Life Lease Application

Application For Housing - Seniors Life Lease

By checking the boxes below, you are agreeing to the following:

I/We hereby, make an application for Mountain View Villa, 375 Whitmore Ave E, Dauphin MB. I /we understand that acceptance is subject to eligibility, approval of the Board of Directors and availability of accommodations.

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I/We understand that there is an entrance fee deposit required:
2- Bedroom $58,000.00 1- Bedroom $53,000.00
Damage deposit: $450.00
Parking (if required) $40.00 / month

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**Once we have received and screened your application, we will reach out to you to request your most recent Income Tax Return**

Are you applying with a co-applicant?(*)

Yes No

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I / We agree to complete the Life Lease agreement and to comply with Mountain View Villas Rules and Regulations By Laws.

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Signature of Applicant(*)

Sign Above

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Signature of Co-applicant(*)

Sign Above

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Page Two MVV

Please answer the following questions to the best of your ability. All information the strictest will be held in of confidence as per the PIPEDA, a federal law that protects the privacy of personal information.

Applicant Name(*)

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Home Phone

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Work Phone

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Cellular Phone

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Date of Birth(*)

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Current Address

Apt./Street No.(*)

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City(*)

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Province(*)

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Postal Code(*)

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Email(*)

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Co-applicant

Co-applicant Name(*)

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Co-applicant Home Phone

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Co-applicant Work Phone

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Co-applicant Cellular Phone

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Co-applicant Date of Birth(*)

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Co-applicant Current Address

Co-applicant Apt./Street No.(*)

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Co-applicant City(*)

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Co-applicant Province(*)

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Co-applicant Postal Code(*)

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Co-applicant Email(*)

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Previous Landlord

How long have you resided at the above address(*)

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What is your current rent(*)

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Current landlord/agent's address(*)

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Current landlord/agent's phone(*)

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Are you a Canadian Citizen?(*)

Yes No

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What was your previous address(*)

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If you own your current home, list the address

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How long did you live there

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Page Four MVV

Please provide any other information you may feel is necessary

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Signature of Applicant(*)

Sign Above

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Signature of Co-applicant(*)

Sign Above

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Application For Housing - Seniors Life Lease

Page Two MVV

Current Address

Co-applicant

Co-applicant Current Address

Previous Landlord

Page Three MVV

Accommodations Required

Financial Information

Co-applicant Financial Information

References

Page Four MVV

Phone

Mountain View Villa